Ovestin cream

Hi Shiz71,

Thanks for getting in touch and welcome to the online community. I hope you find it supportive.

I’m so sorry to see that you’re struggling with the side effects of Letrozole, particularly vaginal dryness which is making sex very painful and that the non-hormonal treatments you’ve tried haven’t worked for you. It’s natural that you miss being intimate with your husband and lovely to see that he’s being so supportive.

 It’s understandable that you have questions about using oestrogen cream after a diagnosis of estrogen positive breast cancer.

On this platform we can give general information, but we’d always suggest you contact your team for further discussion and specific advice about the risks and benefits of oestrogen treatment for you.

The long-term risks of using products containing oestrogen after breast cancer are unknown. However, some breast specialists think very little of the oestrogen is absorbed and may prescribe some of these treatments for short periods of time.

 If you’re taking an aromatase inhibitor such as Letrozole, vaginal oestrogen is not usually recommended as it can reduce the effectiveness of the medication. Vaginal oestrogen may be more safely prescribed for women taking tamoxifen, because tamoxifen is thought to counteract any oestrogen entering the bloodstream. You may like to ask your Breast Team whether changing to Tamoxifen might be an option for you.  

In the meantime, you might like to talk to your GP about a referral to a Sex Therapist, they have training in helping people with various sexual problems including painful sex. Macmillan  and Breast Cancer Now also have this information about sex and intimacy after cancer treatment that you may find helpful.

You may also like to speak to one of our Cancer Information Nurse Specialists on the support line who would be able to discuss this with you in more detail.

I hope this helps, but if you have any more questions please don’t hesitate to get back in touch.

Best Wishes

Rachel  

Cancer Information Nurse Specialist

REF: RC/LZD

Hello Rachel

thanks so much for your reply and i am sorry that i havent replied sooner. I have been waiting on seeing the gynaecologist again and then also speaking with my cancer team and relaying all the info and advice that iv received. Gynaecologist gave me a few options, 1. Continue using instillagel to numb the pain. 2. Ovestin cream. 3. Operation to remove scar tissue but that could make things worse as it would be creating a new wound and possibly same issues with scar tissue. Im due reviewed by them in 4 months. I had telephone consultation with cancer team, as about 5 weeks ago i stopped the letrazole as my blood pressure was high 170/106, and consistently so, i wasnt feeling good and had serious problems with my eye, the breast cancer team told me to stop it and monitor bp, it came down within 2days of stopping it and generally i started to feel better. She said i seemed to be suffering from the rarer side effects. I spoke with the cancer doc and said about the tamoxifen and the advice you gave me. He has said i have to go on tamoxifen now, although this has still to get through to my gp to prescribe. He also said to try the ovestin. And he will review in 4 months to see how im tolerating it. Gyn have said that i could take ovestin it for either 3weeks then stop it for 3weeks or 3months then stop it 3months. Im desperate to get started on tamoxifen as i feel that is another defence against cancer. I just feel anxious about taking ovestin due to being estrogen positive. I cant seem to feel easy about it as drs dont give me any sort of guarantees, it’s basically if you want to take it. Its like im the first patient thats had this problem, which im absolutely sure i cant be. Do you know of any studies etc that i could refer to that discusses taking ovestin in my situation? Iv even considered contacting private healthcare just to see if i can get someone that has maybe treated someone similar to me. Sorry for all this and many many thanks for the wonderful work that you do cheers shirley xx

Hello Shirley

Thanks for getting back in touch with Macmillan’s online community. My name is Helen, I’m one of the Cancer Information Nurses on the Macmillan Support Line.

It was good to know that you found my colleague Rachel’s information useful when you contacted us before, and I am glad that you have started to feel more like yourself having stopped the letrozole and hope the change to tamoxifen will have fewer side effects.

I was sorry to read that since contacting us you have continued  to struggle with vaginal dryness and painful sex. There are few clinical trials looking specifically at the risk of using of topical oestrogen for the reduction of menopausal symptoms in women who had a previous breast cancer, and this will lead your clinicians to be cautious in giving any guarantees.

However, oestrogen creams do get prescribed when other solutions have not helped. I have linked a patient information leaflet from Royal United Hospitals that might be helpful to take a look.

The British Menopause Society (BMS) state that women with a previous breast cancer, for whom non-hormonal alternatives have not been helpful, should be referred to a menopause specialist. You mentioned considering having a private consultation and wondered (if you struggle to access a menopause specialist under the NHS) if the BMS’s information on finding a menopause specialist in your area might be helpful.

I hope this information is useful. Please don’t hesitate to get back in contact by email, webchat or phone, if you need further information or support.

The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm.

Best wishes, Helen

Cancer Information Nurse Specialist 

Ref HM/KS